Synthesis, Crystal Structure, and Luminescence of Cadmium(II) and Silver(I) Coordination Polymers Based on 1,3-Bis(1,2,4-triazol-1-yl)adamantane.

Coordination polymers with a new rigid ligand 1,3-bis(1,2,4-triazol-1-yl)adamantane (L) were prepared by its reaction with cadmium(II) or silver(I) nitrates. Crystal structure of the coordination polymers was determined using single-crystal X-ray diffraction analysis. Silver formed two-dimensional coordination polymer [Ag(L)NO3]n, in which metal ions are linked by 1,3-bis(1,2,4-triazol-1-yl)adamantane ligands, coordinated by nitrogen atoms at positions 2 and 4 of 1,2,4-triazole rings. Layers of the coordination polymer consist of rare 18- and 30-membered {Ag2L2} and {Ag4L4} metallocycles. Cadmium(II) nitrate formed two kinds of one-dimensional coordination polymers depending on the metal-to-ligand ratio used in the synthesis. Coordination polymer [Cd(L)2(NO3)2]n was obtained in case of a 1:2 M:L ratio, while for M:L = 2:1 product {[Cd(L)(NO3)2(CH3OH)]·0.5CH3OH}n was isolated. All coordination polymers demonstrated ligand-centered emission near 450 nm upon excitation at 370 nm.

Hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failure.

AIMS: Despite recent advances in guideline-directed therapy, rehospitalization rates for acute decompensated heart failure (ADHF) remain high. Recently published studies demonstrated the emerging role of hypochloraemia as a predictor of poor outcomes in patients with ADHF. This study sought to determine the correlation between low serum chloride and 30 day hospital readmission in patients with ADHF. METHODS AND RESULTS: We retrospectively reviewed electronic medical records of 1504 patients who were admitted to one 700 bed US tertiary care centre with the diagnosis of ADHF between June 2013 and December 2014. Of the 1504 reviewed records, 1241 were selected for further analysis. Hypochloraemia (either on admission or at discharge) was identified in 289 patients (23.3%) and was associated with significantly higher 30 day hospital readmission rate or death (42.2% vs. 33.7%, P = 0.008). This association persisted in multivariate analysis when controlling for serum sodium, weight loss, diuretic dose, adjunct thiazide use, serum blood urea nitrogen, and BNP levels (OR: 1.35, 95% CI: 1.02-1.77, P = 0.033); however, the predictive value of the overall model was low (Naglkerke R2 = 0.040). Hypochloraemia was also found to be associated with increased 12 month mortality in our cohort (31.4% vs. 20.2%, P = 0.015) that correlates with the results of previously published studies. CONCLUSIONS: Low serum chloride measured in patients admitted for ADHF is independently but weakly associated with increased 30 day readmission rate and demonstrated low predictive value as a potential biomarker in this cohort.

Clinical Outcomes of Successful Revascularization of Chronic Total Coronary Occlusions with Bioresorbable Vascular Scaffolds: A Systematic Review.

Revascularization of chronic total occlusions (CTO) with percutaneous coronary intervention is associated with favorable long-term clinical and echocardiographic outcomes. Whether bioresorbable vascular scaffolds (BVS) would be advantageous in the treatment of CTO is unknown as patients with these lesions were generally excluded from large BVS randomized trials. We performed a systematic review, which sought to summarize known data on mid- to long-term clinical outcomes for BVS in CTO. We searched MEDLINE, EMBASE, clinicaltrials.gov, and the Cochrane Library through April 2018 to look for studies on implantation of BVS in CTO. Outcomes of interest included myocardial infarction, cardiac death, all-cause mortality, major adverse cardiac events (MACE), vessel restenosis, scaffold thrombosis, and target lesion revascularization. A total of 13 articles met the inclusion criteria for analysis. All studies were observational with a total number of patients of 1,077. Only two studies included comparator groups which retrospectively compared BVS with drug-eluting stents (DES). The studies had variable size (21 to 537) and follow-up duration (3-23 months). The review showed favorable outcomes for BVS implantation in CTO with the reported incidence of MACE ranged from 0% to 6.7% with no significant differences between BVS and DES groups in double arm studies. Although data on the use of first-generation BVS in CTO are sporadic and limited by small sample observational studies, available evidence is promising and suggests of acceptable outcomes comparable with second generation DES. Further investigation with randomized clinical trials and use of newer generation scaffolds is required.

Ventricular Tachycardias: Characteristics and Management.

Ventricular tachycardias include ventricular tachycardia, ventricular fibrillation, and torsades de pointes; although these rhythms may be benign and asymptomatic, others may be life threatening and lead to increased morbidity and mortality. To optimize patient outcomes, ventricular tachycardias need to be rapidly diagnosed and managed, and often the electrocardiogram (ECG) is the first and only manifestation of a cardiac defect. Understanding of the initial electrocardiographic pattern and subsequent changes can lead to early intervention and an improved outcome. This article describes mechanisms, ECG characteristics, and management of ventricular tachycardias.